SELA Account Activation

Thank you for choosing to activate a Software for Ergonomic Learning and Assessment account.

Please provide the following information about the individual that will be completing the E-Learning modules and the workstation ergonomic self-assessment:

ACTIVATE A USER ACCOUNT FOR:

first and last Name: *
email: *


COMPANY INFORMATION

Company Name: *
Policy Number:
Company Location (city): *
Department Name: *


REQUESTOR INFORMATION

Name of the individual initiating this request: *
Email of the individual initiating this request: *


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